Treatment of cubitus varus using the Ilizarov technique of distraction osteogenesis

Karatosun, Vasfi; Alekberov, C.; Alıcı, Emin; Ardiç, C. O.; Aksu, Gamze Melek

doi:10.1302/0301-620x.82b7.0821030

Cited by 30 publications

(12 citation statements)

References 19 publications

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“…Importantly, the lateral approach is possibly the safest. Although the medial approach can help conceal the surgical scars, there is a higher associated risk of injury to the ulnar nerve [ 25 ]. In this regard, some surgeons prefer the posterior triceps-splitting approach combined with osteotomy of the olecranon; however, this approach may lead to radial and ulnar nerve palsy [ 26 ], and a higher risk of stiffness[ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

A novel method of lateral closing wedge osteotomy for cubitus varus deformity in children

Xie

Guo

2022

BMC Surg

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Background Humeral osteotomy is the best method for treatment of severe cubitus varus in children. Many osteotomy methods have been developed in the past. In this study, we describe a novel corrective technique by applying the principles described by Paley involving lateral osteotomy using Kirschner wires (K-wires). Vertices of the osteotomy should be located at the center of rotation of angulation. The anatomical and mechanical axes can be corrected with precision. Patients and methods In this retrospective study, 21 patients (17 male, 4 female) who fulfilled the study criteria and underwent lateral closing osteotomy for cubitus varus deformity from July 2015 to October 2017 were included into the study. The osteotomy line of all patients was designed according to Paley’s principles. An isosceles triangle template was made according to the design preoperatively. The lateral osteotomy was made with the assistance of C-arm radiographs. The osteotomy was fixed by K-wires laterally. Patients were followed up, and elbows were evaluated by radiography and using the Mayo Elbow Performance Index (MEPI) score. Results The mean correction angle obtained was 32.33°±2.83°. According to the MEPI score assessment, 19 of the 21 patients had an excellent outcome and two had a good outcome. Two patients complained of conspicuous scars; however, no further cosmetic surgery was performed. The range of motion was 135.0° preoperatively and 133.7° postoperatively, showing no significant difference (p = 0.326). None showed evidence of neurovascular injury or complained of prominence of the lateral humerus. Conclusion Paley’s principles for correcting cubitus varus deformity in children are effective and reliable for treating such a condition. Level of evidence Therapeutic IV.

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Section: Discussionmentioning

confidence: 99%

A novel method of lateral closing wedge osteotomy for cubitus varus deformity in children

Xie

Guo

2022

BMC Surg

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“…Lateral closing wedge osteotomy of the humerus is an effective treatment with a reliable outcome [106]. Alternative techniques have also been described including a step-cut osteotomy [107,108], dome osteotomy [109], distraction external fixator [110] and computer-aided osteotomies [111].…”

Section: Cubitus Varusmentioning

confidence: 99%

Overview of the contemporary management of supracondylar humeral fractures in children

Duffy¹,

Oliver²,

Gelfer

et al. 2021

Eur J Orthop Surg Traumatol

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Purpose Supracondylar fractures are common injuries accounting for approximately 15% of all fractures in children with a large body of literature on this subject. Methods This article critically appraises the available evidence to provide an overview of the treatment options including the role and timing of surgery, the geometry of wire fixation and the management of nerve and arterial injury. Conclusion Management decisions are based on a number of considerations particularly fracture stability. Closed reduction and percutaneous K-wire stabilisation are commonly recommended for an unstable displaced fracture. These techniques are however associated with the potential for iatrogenic neurological injury. Vascular injury is also rare but must be recognised and treated promptly to avoid significant permanent morbidity.

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“…Furthermore, the tendency of the distal fragment to angulate into varus following internal fixation by screws or staples often resulted in a recurrence of the deformity [16]. This led to the emergence of external fixation, ranging from simple monolateral to circular fixators, as an alternative modality of fixation [17][18][19][20][21][22][23][24][25]. Amongst the various devices available, the circular fixator of Ilizarov allows for simultaneous correction of the deformity in three planes [25].…”

Section: Introductionmentioning

confidence: 99%

Post-traumatic cubitus varus: long-term follow-up of corrective osteotomy using the Ilizarov method of compression distraction osteogenesis

Agrawal

Agrawal²,

Kaul

et al. 2020

Journal of Pediatric Orthopaedics B

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The term cubitus varus describes the inward inclination of the supinated forearm on the extended elbow. The deformity manifests clinically as a decreased carrying angle, decreased range of motion (ROM) along with a cosmetically unsightly appearance. The aim of the present study was to evaluate the technique of compressiondistraction osteogenesis using the Ilizarov apparatus in the management of patients with post-traumatic cubitus varus deformity. The objectives were to study the impact of this method on the ROM, the Humerus Elbow Wrist (HEW) angle as well as the Lateral Prominence Index. A total of 32 patients who presented with a cubitus varus deformity of ≥10° at the elbow were retrospectively analyzed using data retrieved from a computerized hospital database. All patients had undergone a miniincision subperiosteal osteotomy followed by application of an Ilizarov frame. Cinico-radiological follow-up was carried out at regular intervals until union was achieved and yearly thereafter. The mean time to union was 11 weeks. The mean follow-up period ranged from 2 to 12 years (mean 4.0 years). Results were graded as excellent in 25 cases (78.1%), good in 2 (6.3%) and poor in 5 case (15.6%) using the grading system of Oppenheim. The mean HEW angle at final follow-up improved from 20° of varus to 6° of valgus. The mean flexion/extension improved from 121°/−3° preoperatively to 125°/−4° at final follow-up. The Mayo Elbow Performance scores at final follow-up were excellent in 23 cases, good in 7 and fair in 2. Complications encountered included superficial pintract infections in three cases, lateral condylar prominence in one case, loss of terminal flexion in three cases and valgus over-correction in one case.

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Treatment of cubitus varus using the Ilizarov technique of distraction osteogenesis

Cited by 30 publications

References 19 publications

A novel method of lateral closing wedge osteotomy for cubitus varus deformity in children

A novel method of lateral closing wedge osteotomy for cubitus varus deformity in children

Overview of the contemporary management of supracondylar humeral fractures in children

Post-traumatic cubitus varus: long-term follow-up of corrective osteotomy using the Ilizarov method of compression distraction osteogenesis

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